What Does D.R.E.S.S. Look Like?

D.R.E.S.S. Syndrome isn't pretty but it's important to know what it looks like.  Most patients (not all!) present with a maculopapular, pruritic rash of the face, upper trunk and extremeties.  The rash can begin on trunk and move down the body and eventually develop into severe exfoliative dermatitis.  Edema of the face and extremities is also common, as is mucosal involvement.

While these are the visual cues for DRESS, the most dangerous damage is done internally where it can't be seen.  Even after the rash and edema subside, the organs can progressively get worse.  We must look beneath the skin to evaluate for these signs.  

Illness- Izzy back-rash 1st ER

Morbilliform rash two weeks after taking Bactrim

DRESS photo from MA.

Morbilliform rash on legs

BiVad 2

The progressive nature of DRESS at it's worst.


Extreme facial edema


Rash moving down legs almost 12 days after first symptoms of DRESS. Swollen legs and bruised feet.

Illness- Izzy Peeling skin hand

Exfoliating skin three weeks into DRESS Syndrome.